Eating Disorders: More than Skin Deep

At this point, most people are able to agree that social media, photoshop, fad diets, and the traditional gaunt runway model’s body type contribute to unrealistic expectations of how our bodies “should” look and what it means to be beautiful. And as more and more celebrities, adults, parents, and teenagers discuss their struggles with eating disorders, the public is becoming more aware of how prevalent eating disorders are in our communities.

Yet, so many people who I speak with struggling with disordered eating behaviors, whether eating too much, not enough, or engaging in some compensatory behavior following meals (i.e. self-induced vomitting, excessive exercise, using laxatives), repeatedly share stories of loved ones instructing them to “just eat” or “just workout” or “just stop”. These well-meaning statements show that even as people become more aware of eating disorders, they clearly lack understanding of the function that eating disorders have in the lives of individuals struggling with them and underestimate how difficult it can be to change a behavior that one has relied on for so long to survive.

There seems to be a general assumption that people with eating disorders are self-centered, image focused, underweight, vain young white women just trying to make themselves “prettier” for those around them or lazy people who just don’t care about their health. However, most clients I see with eating disorders couldn’t be further from this— they are typically generous, hard working, and caring individuals, more sensitive to the needs of others around them than the average Joe. So if they’re not self-obsessed or uncaring, why do they engage in an eating disorder?

For many individuals, the eating disordere developed as a way to adapt to difficult situations and almost never began with a conscious decision to stop eating, eat too much, or purge. Instead, the behavior developed unconsciously when nothing else seemed to work. Most often, the behavior develops as a way of coping with uncomfortable emotions. For example, when someone is highly anxious with “butterflies in the stomach”, eating on top of the anxiety is uncomfortable. So they beginning not eating or restricting develop as a way of avoiding the anxiety and subsequent physical symptoms. If you’re feeling lonely or sad, eating can serve as a means of comfort and soothing. If you’re overcome with anger but unable to express it verbally, purging can develop as way to feel a release. Again, the decision to engage in these behaviors is rarely conscious but many people struggling with these behaviors are able to recognize how the behaviors serve them upon reflection.

Certain patients engage in the eating disorder as a way of being heard, of making their problems visible if they feel unable or unwilling to voice them verbally to those around them. Even though many people with eating disorders avoid conversations about weight and food, the changes in their body are often a sign of a bigger issues— with issues ranging from feeling stressed or rejected to feeling like a total failure.

For those that have been victims of trauma, the eating disorder can be a way of protecting one’s self by altering one’s body to be either smaller or larger, commonly attempting to avoid how their body looked at the time of the trauma. By distancing themselves from their physical appearance at that time, they can then feel they will be less likely to experience a similar trauma in the future.

Lastly, as humans we are creatures of habit and sometimes that is the main role of the disordered eating behaviors, to provide predictability and structure. This may come from engaging in a specific routine around food or predictability in the types of food or tastes that one consumes. Even if the routine is undesirable, typically the devil you know is preferred to the unknown.

Which brings me to my final point. Changing these behaviors takes time. The unknown can be scary. Habits are hard to break. Not to mention that individuals are typically trying to make these changes at moments of extreme vulnerability— when they’re feeling sad, alone, angry, frustrated, anxious, and/or as if they’ve failedduring times of transition in life behaviors. Remember that it’s about more than the food and be curious, ask yourself or your loved one what else might be leading to feelings of distress. Try to identify what’s being felt before using behaviors and see if there are any patterns. Seek support from those close to you and from a therapist or dietitian. Remember change is difficult and we all need help– that’s what makes us all human.